What are the problems caused due low testosterone levels?

Greetings. I have been concerned for the last year about the effects of lower testosterone which accompany age and overweight. My number when tested by the urologist was about 175, which was at least half of what it should be. I read about all kinds of claims about the dangers of lower testosterone and the benefits of increasing it with natural products (rather than pharmaceutical ones which I have read could create risks for prostate problems).
What is your assessment about this issue? Should I need to be concerned, and what should I do about it besides of course losing weight, which I assume would raise my number beyond 175? Thanks.

Brief Answer:
Testosterone
Detailed Answer:
You are correct weight loss will help.
But I would like to emphasize a few things:
1 The right way to test for testosterone is to do it early in the morning between 7-9 am. It does not have to be fasting. As the day progresses the levels drop and that is normal.
2 Further tests like albumin and SHBG (Sex Hormone Binding Globulin) are helpful in determining the free testosterone levels that matter more than Total.
3 To my knowledge there are no published data in scientific literature that the effects of natural versus pharmaceutical testosterone are different on the prostate.
4 If you have sleep apnea, then treating that may improve testosterone levels

Follow-up: What are the problems caused due low testosterone levels? 8 hours later

Thank you very much. Despite my urologist telling me not to worry about it, would I want to try a natural remedy to push up my number? The blood sample with 175 testosterone last year was in the afternoon. And what effect does low testosterone have that one should be concerned about?

Answered by Dr. Shehzad Topiwala 2 hours later

answer Id 295088; conversation id 303050

Brief Answer:
Follow up
Detailed Answer:
So yes, it is scientifically recommended to check testosterone levels in the early morning at their peak concentrations in the bloodstream.
Low testosterone has multiple potential symptoms like fatigue, low energy/mood/libido, memory and endurance problems, erectile dysfunction and other quality of life issues. it is not a life threatening condition per se.
Expert guidelines discourage the use of non-prescription testosterone formulations and recommend the approved pharmaceutical products only.

Follow-up: What are the problems caused due low testosterone levels? 9 minutes later

My urologist last year did not even question me about issues related to fatigue, endurance, energy, mood, etc. Would you advise me to go to a different one, or even to my primary care physician to discuss this after rechecking the testosterone in the earliest morning, perhaps to obtain prescription meds? Which are the recommended prescription medications for this? Thanks.

Answered by Dr. Shehzad Topiwala 3 minutes later

answer Id 295090; conversation id 303060

Brief Answer:
Further follow up
Detailed Answer:
See an Endocrinologist. Prescription examples are testosterone enanthate/cypionate injections, androgel 1.62%, axiron, testim and androderm to name a few

Follow-up: What are the problems caused due low testosterone levels? 21 minutes later

And these would have no known side effects on prostate or anything else then?
And is it true that this is a vicious cycle, that obesity could lead to lower testosterone, which itself leads to the effects of fatigue, low endurance, etc. , which itself makes it difficult to lose weight, etc.?

Answered by Dr. Shehzad Topiwala 10 hours later

answer Id 295093; conversation id 303358

Brief Answer:
Third follow up
Detailed Answer:
The above mentioned testosterone preparations have the same effects on the prostate. I am not aware of any robust evidence based data that prove that non-pharmaceutical testosterone formulations are safer from any angle vis a vis FDA approved ones.
Your postulation about the vicious cycle can be considered a valid concern from a medical perspective too.